Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 2018-00097 | NC |
N | 207RG0300X | Geriatric Medicine | 245222 | NY |
N | 207RG0300X | Geriatric Medicine | MD-17429 | HI |
NPI | 1124268834 |
---|---|
Provider Name | Evelyn Chang Kwok |
First Address | Winston Salem, NC 27106-3410 |
Second Address | Winston Salem, NC 27106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2009 |
Last Update Date | 30/07/2018 |